Perforation of an subacutely inflammed apendix with formation of an intrahepatic abscess - a case report

Authors

  • Marko Mesić Klinika za dječju kirurgiju, Klinika za dječje bolesti Zagreb, Klaićeva 16, 10000 Zagreb, Hrvatska; Medicinski fakultet Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku, Josipa Huttlera 4, 31000 Osijek, Hrvatska
  • Ljudevit Sović Klinika za dječju kirurgiju, Klinika za dječje bolesti Zagreb, Klaićeva 16, 10000 Zagreb, Hrvatska
  • Nina Krajcar Zavod za infektivne bolesti djece, Klinika za infektivne bolesti „Dr. Fran Mihaljević“, Mirogojska 8, 10000 Zagreb, Hrvatska
  • Maja Vrdoljak Pažur Zavod za infektivne bolesti djece, Klinika za infektivne bolesti „Dr. Fran Mihaljević“, Mirogojska 8, 10000 Zagreb, Hrvatska; Katedra za infektologiju, Medicinski fakultet, Sveučilište u Zagrebu, Šalata 2, 10000 Zagreb, Hrvatska
  • Tonči Grmoja Zavod za dječju radiologiju, Klinika za dječje bolesti Zagreb, Klaićeva 16, 10000 Zagreb, Hrvatska
  • Ana Močić Pavić Zavod za pedijatrijsku gastroenterologiju, hepatologiju i poremećaje prehrane, Klinika za pedijatriju, Klinika za dječje bolesti Zagreb, Klaićeva 16, 10000 Zagreb, Hrvatska
  • Fran Štampalija Klinika za dječju kirurgiju, Klinika za dječje bolesti Zagreb, Klaićeva 16, 10000 Zagreb, Hrvatska
  • Mario Kopljar Kbc “Sestre milosrdnice”, Vinogradska 29, 10000 Zagreb, Hrvatska

DOI:

https://doi.org/10.13112/pc.1133

Keywords:

Liver abscess, Appendicitis, Child, Fever

Abstract

Intrahepatic perforation of an inflamed appendix is an exceptionally rare condition, attributed both to its atypical clinical presentation and the anatomycal variability in the position of the appendix, posing a distinctive diagnostic and therapeutic challenge.

Typically, appendicitis as an entity results in a localized infection or abscess formation within the right lower quadrant of the abdomen.

Here, we report a case demonstrating a specific anatomical variation, presenting with intrahepatic perforation and subsequent hepatic abscess formation in a two-year-old child with atypical clinical presentation.

This case report discusses the underlying pathophysiological mechanisms, diagnostic workup, management strategies, and clinical implications of intrahepatic appendiceal perforation.

Author Biographies

  • Marko Mesić, Klinika za dječju kirurgiju, Klinika za dječje bolesti Zagreb, Klaićeva 16, 10000 Zagreb, Hrvatska; Medicinski fakultet Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku, Josipa Huttlera 4, 31000 Osijek, Hrvatska

    Klinika za dječju kirurgiju, Klinika za dječje bolesti Zagreb, Voditelj Zavoda za abdominalnu kirurgiju

  • Ljudevit Sović, Klinika za dječju kirurgiju, Klinika za dječje bolesti Zagreb, Klaićeva 16, 10000 Zagreb, Hrvatska

    Klinika za dječju kirurgiju, Klinika za dječje bolesti Zagreb

  • Nina Krajcar, Zavod za infektivne bolesti djece, Klinika za infektivne bolesti „Dr. Fran Mihaljević“, Mirogojska 8, 10000 Zagreb, Hrvatska

    Zavod za infektivne bolesti djece, Klinika za infektivne bolesti „Dr. Fran Mihaljević“,
    Zagreb

  • Maja Vrdoljak Pažur, Zavod za infektivne bolesti djece, Klinika za infektivne bolesti „Dr. Fran Mihaljević“, Mirogojska 8, 10000 Zagreb, Hrvatska; Katedra za infektologiju, Medicinski fakultet, Sveučilište u Zagrebu, Šalata 2, 10000 Zagreb, Hrvatska

    Zavod za infektivne bolesti djece, Klinika za infektivne bolesti „Dr. Fran Mihaljević“,
    Zagreb

    Katedra za infektologiju, Medicinski fakultet, Sveučilište u Zagrebu

  • Tonči Grmoja, Zavod za dječju radiologiju, Klinika za dječje bolesti Zagreb, Klaićeva 16, 10000 Zagreb, Hrvatska

    Zavod za dječju radiologiju, Klinika za dječje bolesti Zagreb

  • Ana Močić Pavić, Zavod za pedijatrijsku gastroenterologiju, hepatologiju i poremećaje prehrane, Klinika za pedijatriju, Klinika za dječje bolesti Zagreb, Klaićeva 16, 10000 Zagreb, Hrvatska

    Zavod za pedijatrijsku gastroenterologiju, hepatologiju i poremećaje prehrane, Klinika za
    pedijatriju, Klinika za dječje bolesti Zagreb

  • Fran Štampalija, Klinika za dječju kirurgiju, Klinika za dječje bolesti Zagreb, Klaićeva 16, 10000 Zagreb, Hrvatska

    Klinika za dječju kirurgiju, Klinika za dječje bolesti Zagreb

  • Mario Kopljar, Kbc “Sestre milosrdnice”, Vinogradska 29, 10000 Zagreb, Hrvatska

    KBC “Sestre milosrdnice”

    Medicinski fakultet Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku

References

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14. Yeh PJ, Chen CC, Lai MW, Yeh HY, Chao HC. Pediatric Liver Abscess: Trends in the Incidence, Etiology, and Outcomes Based on 20-Years of Experience at a Tertiary Center. Front Pediatr. 2020;8:111.

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naslovnica Paediatria Croatica volumen 69 broj 4 2025

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Published

2025-12-16

Issue

Vol. 69 No. 4 (2025)

Section

Case Report

License

Copyright (c) 2025 Marko Mesić, Ljudevit Sović, Nina Krajcar, Maja Vrdoljak Pažur, Tonči Grmoja, Ana Močić Pavić, Fran Štampalija, Mario Kopljar

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

By publishing in Paediatria Croatica, authors retain the copyright to their work and grant others the right to use, reproduce, and share their research articles in accordance with the Creative Commons Attribution License (CC BY 4.0), which allows others to distribute and build upon the work as long as they credit the author for the original creation.

How to Cite

Mesić, M., Sović, L., Krajcar, N., Vrdoljak Pažur, M., Grmoja, T., Močić Pavić, A., Štampalija, F., & Kopljar, M. (2025). Perforation of an subacutely inflammed apendix with formation of an intrahepatic abscess - a case report. Paediatria Croatica, 69(4), 239-243. https://doi.org/10.13112/pc.1133

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